Eggebrecht, Holger, Vaquerizo, Beatriz ORCID: 0000-0002-1428-3596, Moris, Cesar ORCID: 0000-0002-2871-190X, Bossone, Eduardo, Laemmer, Johannes, Czerny, Martin, Zierer, Andreas, Schroefel, Holger, Kim, Won-Keun, Walther, Thomas, Scholtz, Smita, Rudolph, Tanja, Hengstenberg, Christian, Kempfert, Joerg, Spaziano, Marco, Lefevre, Thierry, Bleiziffer, Sabine, Schofer, Joachim, Mehilli, Julinda, Seiffert, Moritz, Naber, Christoph, Biancari, Fausto ORCID: 0000-0001-5028-8186, Eckner, Dennis, Cornet, Charles ORCID: 0000-0002-1363-7401, Lhermusier, Thibault, Philippart, Raphael, Siljander, Antti, Cerillo, Alfredo Giuseppe ORCID: 0000-0003-3430-2333, Blackman, Daniel, Chieffo, Alaide, Kahlert, Philipp, Czerwinska-Jelonkiewicz, Katarzyna, Szymanski, Piotr ORCID: 0000-0001-9486-7892, Landes, Uri, Kornowski, Ran, D'Onofrio, Augusto, Kaulfersch, Carl, Sondergaard, Lars, Mylotte, Darren, Mehta, Rajendra H. and De Backer, Ole ORCID: 0000-0002-9674-0278 (2018). Incidence and outcomes of emergent cardiac surgery during transfemoral transcatheter aortic valve implantation (TAVI): insights from the European Registry on Emergent Cardiac Surgery during TAVI (EuRECS-TAVI). Eur. Heart J., 39 (8). S. 676 - 685. OXFORD: OXFORD UNIV PRESS. ISSN 1522-9645

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Abstract

Aims Life-threatening complications occur during transcatheter aortic valve implantation (TAVI) which can require emergent cardiac surgery (ECS). Risks and outcomes of patients needing ECS during or immediately after TAVI are still unclear. Methods and results Incidence, risk factors, management, and outcomes of patients requiring ECS during transfemoral (TF)-TAVI were analysed from a contemporary real-world multicentre registry. Between 2013 and 2016, 27 760 patients underwent TF-TAVI in 79 centres. Of these, 212 (0.76%) patients required ECS (age 82.4 +/- 6.3 years, 67.5% females, logistic EuroSCORE: 17.1%, STS-score 5.8%). The risk of ECS declined from 2013 (1.07%) to 2014 (0.70%) but remained stable since. Annual TF-TAVI numbers have more than doubled from 2013 to 2016. Leading causes for ECS were left ventricular perforation by the guidewire (28.3%) and annular rupture (21.2%). Immediate procedural mortality (< 72 h) of TF-TAVI patients requiring ECS was 34.6%. Overall in-hospital mortality was 46.0%, and highest in case of annular rupture (62%). Independent predictors of in-hospital mortality following ECS were age > 85 years [odds ratio (OR) 1.87, 95% confidence interval (95% CI) (1.02-3.45), P = 0.044], annular rupture [OR 1.96, 95% CI (0.94-4.10), P = 0.060], and immediate ECS [OR 3.12, 95% CI (1.07-9.11), P = 0.037]. One year of survival of the 114 patients surviving the in-hospital period was only 40.4%. Conclusion Between 2014 and 2016, the need for ECS remained stable around 0.7%. Left ventricular guidewire perforation and annular rupture were the most frequent causes, accounting for almost half of ECS cases. Half of the patients could be salvaged by ECS-nevertheless, 1 year of all-cause mortality was high even in those ECS patients surviving the in-hospital period.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Eggebrecht, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vaquerizo, BeatrizUNSPECIFIEDorcid.org/0000-0002-1428-3596UNSPECIFIED
Moris, CesarUNSPECIFIEDorcid.org/0000-0002-2871-190XUNSPECIFIED
Bossone, EduardoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Laemmer, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Czerny, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zierer, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schroefel, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kim, Won-KeunUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Walther, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scholtz, SmitaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rudolph, TanjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hengstenberg, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kempfert, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spaziano, MarcoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lefevre, ThierryUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bleiziffer, SabineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schofer, JoachimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mehilli, JulindaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seiffert, MoritzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Naber, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Biancari, FaustoUNSPECIFIEDorcid.org/0000-0001-5028-8186UNSPECIFIED
Eckner, DennisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornet, CharlesUNSPECIFIEDorcid.org/0000-0002-1363-7401UNSPECIFIED
Lhermusier, ThibaultUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Philippart, RaphaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Siljander, AnttiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cerillo, Alfredo GiuseppeUNSPECIFIEDorcid.org/0000-0003-3430-2333UNSPECIFIED
Blackman, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chieffo, AlaideUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kahlert, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Czerwinska-Jelonkiewicz, KatarzynaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Szymanski, PiotrUNSPECIFIEDorcid.org/0000-0001-9486-7892UNSPECIFIED
Landes, UriUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kornowski, RanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
D'Onofrio, AugustoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kaulfersch, CarlUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sondergaard, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mylotte, DarrenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mehta, Rajendra H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Backer, OleUNSPECIFIEDorcid.org/0000-0002-9674-0278UNSPECIFIED
URN: urn:nbn:de:hbz:38-195630
DOI: 10.1093/eurheartj/ehx713
Journal or Publication Title: Eur. Heart J.
Volume: 39
Number: 8
Page Range: S. 676 - 685
Date: 2018
Publisher: OXFORD UNIV PRESS
Place of Publication: OXFORD
ISSN: 1522-9645
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ANNULUS RUPTURE; TEMPORAL TRENDS; REPLACEMENTS; METAANALYSIS; GERMANY; THERAPY; PATIENT; SOCIETY; ROOTMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/19563

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